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Observing communication skills for informed consent: an examiner's experience
1St. Michael's Hospital, 30 Bond St., Toronto ON M5B 1W8, Canada.
Annals (Royal College of Physicians and Surgeons of Canada)
|October 16, 2002
Summary
Medical students demonstrated strong communication skills for physical concerns but struggled with psychological aspects during informed consent. Further training is needed to improve patient-centered communication and autonomous decision-making support.
Area of Science:
- Medical Education
- Clinical Skills Assessment
- Patient Communication
Background:
- Informed consent is crucial for patient autonomy and ethical medical practice.
- Assessing medical students' competence in obtaining informed consent is essential.
- Objective Structured Clinical Examinations (OSCEs) are used to evaluate clinical skills.
Purpose of the Study:
- To evaluate medical students' communication skills and competence in obtaining informed consent.
- To identify areas for improvement in clinical skills related to informed consent.
Main Methods:
- An Objective Structured Clinical Examination (OSCE) station focused on informed consent was administered to 22 medical licensing candidates.
- Performance was assessed using binary checklists and global ratings, evaluating problem approach, knowledge, attitude, and communication.
Main Results:
- 90% of candidates effectively addressed patients' physical concerns.
- Only 50% conducted relevant mental status examinations and demonstrated patient-centered communication.
- Many candidates overlooked psychological factors influencing patient decisions and failed to adequately support autonomous choices.
Conclusions:
- OSCE is effective for evaluating clinical competence in obtaining informed consent.
- Significant gaps exist in students' ability to address psychological aspects and support patient autonomy.
- Undergraduate medical education should emphasize improving skills in assessing patient competency and facilitating informed consent.